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Childbirth outcomes and perineal damage in women with natural childbirth in Korea: a retrospective chart review (자연주의 출산한 여성의 출산실태와 회음부 손상: 일개 자연주의 출산병원 의무기록을 중심으로)

  • Kim, Kyung Won;Lee, Sunhee
    • Women's Health Nursing
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    • v.27 no.4
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    • pp.379-387
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    • 2021
  • Purpose: This study aimed to determine the actual state of childbirth in Korean women with natural childbirth and the degree of damage to the perineum during childbirth. Methods: This retrospective study analyzed the medical records of mothers who had natural childbirth at a hospital in Seoul, Korea in 2018. Data from 358 women with cephalic births at greater than 37 gestational weeks were analyzed. To determine natural childbirth characteristics and the degree of damage to the perineum, descriptive statistics were done. The difference in the degree of perineal injury according to obstetric characteristics was analyzed using independent t-test and one-way analysis of variance. Results: The mean age was 33.18±3.68 years, and 49.2% were primiparas, while 39% gave birth with a doula. The degree of perineal damage differed by age (F=9.15, p<.001), parity (t=19.13, p<.001), number of births in multiparity (F=3.68, p=.027), previous vaginal delivery in multiparity (F=3.00, p=.032) and birthing posture (F=7.44, p<.001). Having received therapeutic procedures (t=-4.62, p<.001), specifically fluid administration (t=-2.72, p=.007), oxygen supply (t=-2.76, p=.006) and epidural anesthesia (t=-2.77, p=.006) were statistically significant for perineal damage. There were no differences, however, by gestational period, doula use, water room use in labor, baby head circumference, or birth weight. Conclusion: Study findings suggest that support for older women, primiparas, and those who require therapeutic procedures may help to decrease the possibility of perineal damage during childbirth. As perineal damage was also associated with birthing posture, this should be considered when providing intrapartum nursing care.

A Study on Fashion Color Preferences According to the Fashion Interest and Lifestyle of the New Silver Generation (뉴 실버 세대의 패션관심도와 라이프스타일에 따른 패션 색채 선호도 연구)

  • Lee, Semi;Koo, Sumin
    • Journal of Fashion Business
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    • v.25 no.5
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    • pp.38-56
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    • 2021
  • The New Silver Generation, which includes retired baby boomers, is eschewing traditional lifestyles, remaining socially and economically active, and striving to enjoy their lives. It is necessary to understand the preferences, sensibilities, and fashion propensities of such individuals. Thus, this study analyzed the New Silver Generation's fashion color preferences and proposed fashion color scheme guidelines that could be used in the fashion industry. First, surveys were conducted in people of the New Silver Generation aged from 55 to 65 years. The survey questions included the following: fashion color preferences, fashion sensibility and taste preferences, fashion interests, lifestyle, and demographic background. Second, the survey was conducted to identify differences in color preferences based on respondents' fashion interests and lifestyles. Next, to compose color palettes for the survey, 45 colors from the Munsell color system were chosen at random. The major research results were as follows: It was shown that socializing- and health-preferring individuals wore achromatic color, leisure-preferring individuals wore P color, and self-preferring individuals wore B color. The commonly worn colors were achromatic colors. After the age of 55 years, health- and leisure-preferring individuals often wore R color and RP color, respectively. Thus, this study proposed a color scheme arrangement that used achromatic colors, such as black and white, as the main colors list for the four lifestyle types.

Development of a Demand Model for Physician Workforce Projection on Regional Inequity Problem in Korea Using System Dynamics (시스템 다이내믹스를 활용한 지역별 국내 의사인력 수요에 대한 추계모델 개발)

  • Lee, Gyeong Min;Yoo, Ki-Bong
    • Health Policy and Management
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    • v.32 no.1
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    • pp.73-93
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    • 2022
  • Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion: This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

Upper Body Type Analysis for Middle-aged Women Aged 50-69 Years (50-69세의 중장년 성인여성을 위한 상반신 체형분석)

  • Lee, Jin Hee;Kim, Eun Kyong
    • Journal of the Korea Fashion and Costume Design Association
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    • v.24 no.3
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    • pp.49-61
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    • 2022
  • This study aims to provide upper body shape information by analyzing the measurement data of middle-aged women aged 50-69, including baby boomers, whose economic power and activity have improved compared to the previous generations. In order to provide accurate upper body shape information by analyzing the body type using the 8th Size Korea measurement data, body shapes were classified through factor and cluster analysis using 75 direct measurement items. Upper body type was classified according to the factors, and the associated characteristics were analyzed. As a result of the comparative analysis of the upper body measurements from the 4th to the 8th Size Korea measurement, it was found that in the height item, both the waist height and the hip height increased, making the overall height greater and the leg length longer. The body circumference items tended to increase, but were found to decrease significantly in the 8th Size Korea (2021) measurement. Middle-aged women were classified using five factors. Factor 1 was the upper body obesity factor, and Factor 2 was the trunk vertical factor. Factor 3 was the width of the back shoulder, Factor 4 was the vertical factor behind the back, and Factor 5 was the length factor of the front garment composition. Middle-aged women were classified into four body types through cluster analysis. Type 1 is relatively small and skinny, Type 2 has the most obese upper body and developed back shoulders, and Type 3 is skinny and has a long back and short front. In Type 4, the upper body was relatively long and the shoulders were narrow.

A retrospective study of mothers who received herbal medicine treatment using the Jeollabuk-do postpartum health support project at one korean medicine hospital (일개한방병원에서 전라북도산후건강지원사업을 이용해 한약치료를 받은 산모에 대한 후향적 연구)

  • Jeong, Seo-Yoon;Lee, Eun-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.3
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    • pp.49-64
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    • 2021
  • Objectives: This study analyzed medical records and online survey of mothers who received herbal medicine treatment using the Jeollabuk-do Postpartum Health Support Project. Through this, we would like to discuss the proposal of a postpartum questionnaire of korean medicine for the initial examination, and the project direction. Methods: This study investigated the medical records of 46 mothers who received herbal medicine treatment using the Jeollabuk-do Postpartum Health Support Program at one korean medical hospital. The mother's general characteristics, past history, symptoms, and herbal medicine prescription were analyzed. In addition, through the 33 mothers who responded to the online survey questionnaire, 13 items including medication satisfaction, lactation, and side effects were investigated. Results: The average age of the subjects was 34.46±4.27 years. Musculo-skeletal pain was the most common in both medical records and online surveys. The date of visit from the date of delivery was 47.56±57.15 days. Boheo-tang was prescribed the most, and 84.8% of mothers answered positively about their health after taking herbal medicine. Conclusions: The satisfaction of mothers who received herbal medicine treatment through this project was very high. There were no significant side effects on the mother and the breastfeeding baby who took herbal medicine. In the future, support projects for postpartum korean medical treatment at the national or local level will be necessary.

Burden of Early Life Obesity and Its Relationship with Protein Intake in Infancy: The Middle East Expert Consensus

  • Jochum, Frank;Abdellatif, Mohamed;Adel, Ashraf;Alhammadi, Ahmed;Alnemri, Abdulrahman;Alohali, Eman;AlSarraf, Khaled;Al Said, Khoula;Elzalabany, Mahmoud;Isa, Hasan M.A.;Kalyanasundaram, Sridhar;Reheim, Naguib Abdel;Saadah, Omar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.93-108
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    • 2022
  • Adequate nutrition in early life is proposed to shape a child's future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.

Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital

  • Mary, J. Jenifer Florence;Sindhuri, R.;Kumaran, A. Arul;Dongre, Amol R.
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.201-208
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    • 2022
  • Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

Nurses' attitudes and stress related to perinatal bereavement care in Korea: a cross-sectional survey

  • Kim, Eunhui;Kim, Hae Won
    • Women's Health Nursing
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    • v.28 no.2
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    • pp.134-144
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    • 2022
  • Purpose: A descriptive correlational survey was conducted to examine nurses' attitudes and stress related to perinatal bereavement care (PBC) and their relationships, with the ultimate goal of improving nurses' capabilities related to PBC. Methods: Korean nurses (N=136) who had experienced perinatal death at least once were recruited from seven hospitals. Data were analyzed using descriptive statistics. The Korean version of Nurses' Attitudes towards Perinatal Bereavement Support was assessed in terms of three subdomains (attitudes to PBC, importance of policies related to PBC, and importance of training related to PBC), and nurses' stress was measured. Results: The participants gave high scores for the attitude-related items of "giving sufficient time to bereaved parents to mourn for their dead baby" (4.54 points) and "nurses should treat bereaved parents with respect and dignity" (4.51 points), and they perceived a high level of importance for the policy-related items of "every staff member in the hospital should understand the policies relevant for PBC" and "when nurses feel emotional exhaustion, they should seek support" (4.58 points). Nurses' attitude toward PBC was associated with the perceived importance of policies (r=.40, p<.001), the perceived importance of PBC-related training (r=.61, p<.001), and stress related to PBC (r=.29, p<.001). Nurses' perceived importance of PBC-related training was associated with stress related to PBC (r=.38, p<.001). Conclusion: Establishing hospital policies related to PBC and providing PBC training for nurses could positively affect nurses' attitudes toward PBC. A stress management program for nurses could reduce the stress caused by PBC.

Clinical application of genome-wide single nucleotide polymorphism genotyping and karyomapping for preimplantation genetic testing of Charcot-Marie-Tooth disease

  • Kim, Min Jee;Park, Sun Ok;Hong, Ye Seul;Park, Eun A;Lee, Yu Bin;Choi, Byung-Ok;Lee, Kyung-Ah;Yu, Eun Jeong;Kang, Inn Soo
    • Journal of Genetic Medicine
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    • v.19 no.1
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    • pp.7-13
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    • 2022
  • Purpose: Preimplantation genetic testing for monogenic disorders (PGT-M) has been successfully used to prevent couples with monogenic disorders from passing them on to their child. Charcot-Marie-Tooth Disease (CMT) is a genetic disorder characterized by progressive extremity muscle degeneration and loss of sensory function. For the first time in Korea, we report our experience of applying single nucleotide polymorphism genotyping and karyomapping for PGT-M of CMT disease. Materials and Methods: Prior to clinical PGT-M, preclinical tests were performed using genotypes of affected families to identify informative single-nucleotide polymorphisms associated with mutant alleles. We performed five cycles of in vitro fertilization PGT-M in four couples with CMT1A, CMT2A, and CMT2S in CHA Fertility Center, Seoul Station. Results: From July 2020 through August 2021, five cycles of PGT-M with karyomapping in four cases with CMT1 and CMT2 were analyzed retrospectively. A total of 17 blastocysts were biopsied and 15 embryos were successfully diagnosed (88.2%). Ten out of 15 embryos were diagnosed as unaffected (66.7%). Five cycles of PGT-M resulted in four transfer cycles, in which four embryos were transferred. Three clinical pregnancies were achieved (75%) and the prenatal diagnosis by amniocentesis for all three women confirmed PGT-M of karyomapping. One woman delivered a healthy baby uneventfully and two pregnancies are currently ongoing. Conclusion: This is the first report in Korea on the application of karyomapping in PGT-M for CMT patients. This study shows that karyomapping is an efficient, reliable and accurate diagnostic method for PGT-M in various types of CMT diseases.

Prevalence, Risk Factors, and Pediatrician Awareness of Infant Dyschezia in Indonesia

  • Muzal Kadim;Ucha Merendar Putri;Hartono Gunardi;HF Wulandari;Pustika Amalia Wahidiyat;Sudung O Pardede;Wahyuni Indawati
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.2
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    • pp.116-126
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    • 2023
  • Purpose: This study aimed to evaluate the prevalence and risk factors of infant dyschezia as well as pediatrician awareness regarding this disease in Indonesia. Methods: This is a two-part cross-sectional study, which was divided into study A and B. Study A: Parents whose infants were under 9 months old and attended well-baby clinics were recruited at two randomly selected primary health centers. Parents also provided information on the infant's previous medical history, and socio-demographic and family details. The Rome IV criteria was translated and validated to be used for diagnosis of infant dyschezia. Study B: Randomly selected pediatricians were surveyed by using a questionnaire to evaluate their knowledge regarding infant dyschezia. Results: The prevalence of infant dyschezia based on the result of this study was 11.8%. Three risk factors had a significant relationship with infant dyschezia i.e., the number of children in the family (odds ratio [OR], 5.619; 95% confidence interval [CI], 2.194-14.390; p<0.001), complementary food diet (OR, 4.238; 95% CI, 1.902-9.443; p<0.001), and social-emotional disturbance (OR, 5.670; 95% CI, 2.550-12.609; p<0.001). The percentage of pediatricians correctly diagnosed infant dyschezia was 71.5%. Most pediatricians agreed that they did not perform any diagnostic testing (79.7%) and only provided education in cases of infant dyschezia (58.5%). Conclusion: The prevalence of infant dyschezia identified in our study was higher than that in other neighboring Asian countries, with the highest prevalence observed in infants 7-9 months old. Being an only child, receiving complementary food diet, and sociao-emotional disturbances were significant risk factors of infant dyschezia.